Abstract

In late 2014, the outbreak of Ebola virus disease (EVD) in West Africa was at its peak. Th ose infected numbered in the tens of thousands. "Hotspots" with multiple cases appeared across four nations, both in overcrowded major cities and in isolated rural villages. Hospitals were overfl owing. Th ere were insuffi cient laboratory facilities and trained health care workers to diagnose cases swiftly; and disintegrated or absent public infrastructure in all domains, from roads and sewers to epidemiologists and health promoters, hampered international responders. Nurses and doctors-already far overstretched, and servicing absurd populations at a ratio of 1:1000 even before the outbreak-were often among the fi rst infected and dead.